胸膜

The clinical observation and its nursing process of combining pneumohemothorax in closure rib fracture from 63 examples in our hospital were summarized.49 examples were cured by the pleura cavity puncture or the closed drainage of the pleura cavity.

总结我院收治的63例闭合性肋骨骨折病人合并血气胸的临床观察及相应的护理过程。49例经过胸膜腔穿刺或胸膜腔闭式引流、剖胸探查修补裂口、止血、纠正休克等措施后均治愈，其余14例未作特殊处理自愈。

（1）Bullae of lung ruptured spontaneous pneumothorax is the best indication for VATS,which has the advantages of less trauma and ache,short operation time,quick recovery and small incision;（2）Recurrent unilateral spontaneous pneumothorax with contineous air leakage of 7 days after closed thoracic drainage,bilateral spontaneous pneumothorax should be treated by VATS;（3）Spontaneous pneumothorax with pleura adhesion can be treated by pneumonolysis and bullae of lung excision under thoracoscopy assisted small incision operation.

疗效满意。结论：（1）肺大泡破裂自发性气胸是胸腔镜手术最佳的适应证，与传统开胸手术相比，胸腔镜手术具有患者创伤小，手术时间短，术后疼痛轻，康复快，符合美容要求等特点；（2）反复发作的单侧自发性气胸，行胸腔闭式引流术后持续漏气7d，双侧自发性气胸，不论是否同时发作都可考虑胸腔镜手术治疗；（3）自发性气胸并胸膜粘连可用胸腔镜辅助小切口行粘连松解肺大泡切除术；（4）为减少一次性材料的消耗，降低手术成本，可辅助小切口使用常规胸科手术器械完成手术；（5）为减少术后复发率需行胸膜固定术。

Pleural fluid may collect in the subpleural location and a subpulmonic effusion may be overlooked because it mimics elevation of the hemidiaphragm.

胸膜流体也许在胸膜下的地点收集，并且subpulmonic流出也许被忽略，因为它仿造hemidiaphragm的海拔。

The subpleural arteriole and its branches were short. The subpleural capillary meshes were sparse and web-like, and small holes made of microvessels were found occasionally.

胸膜下微动脉及其分支较短，胸膜下毛细血管网呈现稀疏的网络状，偶尔可见由微血管形成的&小孔状&结构。

The pleural superficial blood vessels were smooth, while the round imprints of endothelial nuclei along the vascular axis and circular constrictions were found on the subpleural arteriole and the terminal arteriole.

胸膜面浅层的微血管铸型表面比较光滑，胸膜下微动脉和终末微动脉表面可以看到沿血管长轴排列的呈圆形的内皮细胞核的压痕，以及规律分布的环状缩窄。

The diagnostic imaging features of COP were patchy or lobar consolidation,often by a predominantly subpleural distribution,and irregular band-like opacities distributed along the bronchovascular bundle or located in the subpleural area.

提示COP诊断的典型胸部CT表现有：胸膜下分布的斑片状或大叶性气腔实变影；沿支气管血管束分布和/或胸膜下分布的不规则条索状影。

Pleural effusion is broken down into two categories, transudates and exudates. A transudate is a clear fluid that forms not because the pleural surfaces are diseased, but because of an imbalance between the normal production and removal of the fluid. The most common cause of transudative fluid is congestive heart failure.

型胸膜流出为二类别、transudates 和渗出液被划分。transudate 是形成的纯净流体不是因为胸膜表面是害病的，但由于一种不平衡状态在流体的正常生产和撤除之间。transudative 流体的同道会是充血的心力衰竭。

Results: There were 14 cases of solitary bronchioloalveolar carcinoma, the distance of pleura to the centre of pulmonary node was smaller than 3.1cm, node diameter from 1.4cm to 3.5cm, the CT morphologic features of nodes were margin slick 2 cases, irregular margin 6 cases, short barb 5 cases, pleural retraction 11 cases, bronchogram 6 cases, vacuole 12 cases. 5 cases of consolidation bronchioloalveolar carcinoma, the main features were multisegment or lobes inflammatory consolidation, bronchogram phase 4 cases, and honeycomb 3 cases. 6 cases of diffused bronchioloalveolar carcinoma, the main features were widespread diffusion nodes, inequality of size, anisodistribute.

结果：孤立结节型14例，结节中心距胸膜均小于3.1cm，病灶直径为1.4~3.5cm，CT表现有边缘光滑2例，呈分叶征6例，短毛刺征5例，胸膜凹陷征11例，含气支气管征6例，空泡征12例；炎症型或实变型5例，病变呈多个肺段或肺叶的炎症样实变，见支气管气相4例，以及蜂房状含气腔3例；弥漫结节型6例，弥漫分布粟粒状与结节状致密影，大小不等，分布不均。

The parietal pleura lines the inner chest wall and the visceral pleura encases the lungs.

壁层胸膜在胸壁内部，脏层胸膜包裹肺脏。

It is because of the proximity of the pleurae to the lung that many people mistakenly think of pleural mesothelioma as a form of lung cancer.

因为胸膜接近于肺，大多数人误认为胸膜间皮瘤是肺癌的一种形式。

The split between the two groups can hardly be papered over.

这两个团体间的分歧难以掩饰。

This approach not only encourages a greater number of responses, but minimizes the likelihood of stale groupthink.

这种做法不仅鼓励了更多的反应，而且减少跟风的可能性。